Roger Severino has long spoken out against the rights of LGBT Americans—but now he's tasked with ensuring those people receive appropriate medical care.

Roger Severino is a former staff member at the Heritage Foundation, a conservative think tank, and attorney for the Department of Justice with a long history of opposing legislation that benefits the LGBTQ community. This week, he was quietly appointed by Donald Trump to head the civil rights division of the Department of Health & Human Services (HHS).

HHS's Office of Civil Rights (OCR) is in charge of ensuring that Americans have access to healthcare despite the possible prejudices of providers. For the last several years, one of the division's significant responsibilities has been the defense and imposition of Section 1557 of the Affordable Care Act, which "prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities." Section 1557 is crucial for transgender people's access to live-saving care. During his previous position, Severino was an active and outspoken opponent of Section 1557 in the name of "religious liberty."

"We have somebody who has actively lobbied against the work of this agency being put in charge of the work of this agency," said Harper Jean Tobin, the director of policy at the National Center for Transgender Equality (NCTE), in an interview with Broadly. Trans people confront "tremendous barriers to healthcare," she explained: Of the 20,000 transgender Americans that the NCTE surveyed in 2015, "nearly a quarter of them said that in the last year they had not gotten healthcare when they needed it because they were afraid of facing discrimination."

As the LGBT community has gotten word of the president's new appointment in the past 24 hours, numerous organizations have come out condemning Severino and voicing their concerns about the health and wellbeing of the people whose civil rights he has made a career out of opposing. Tobin told Broadly she was sickened to witness "another example in this administration of the fox being put in charge of the henhouse."

Severino has openly spoken out against the protection of transgender students' civil rights. In an article written last year, he expressed his belief that trans students should not be protected against discrimination on the basis of sex in education under Title IX. In the same article, Severino called trans women "biological men" and suggested their equal rights threaten the safety of cisgender women.

It seems unlikely that Severino has any interest in ensuring that trans people retain access to medical care, especially considering he's said things like this: "The radical left is using government power to coerce everyone, including children, into pledging allegiance to a radical new gender ideology over and above their right to privacy, safety, and religious freedom."

In what seems to be a pattern, Trump's appointees—from his cabinet members to the EPA head—seem to have professional histories, belief systems, and conflicts of interest that are antithetical to the purposes of the office they now hold, suggesting that they are incapable of doing their jobs without fundamentally altering their purpose. The Leadership Conference on Human and Civil Rights issued a statement condemning Severino's appointment and expressing concern about his ability to do the job he's just been given. "Absent a change by Congress, these offices and their leaders have an obligation to serve the American people, consistent with their mandate," they wrote.

Tobin called his appointment "extreme" and "unacceptable," warning that Severino very well may jeopardize the health of millions of Americans whose access to appropriate treatment is already difficult to attain. "We're especially worried about the impact on the over 1.5 million Americans who are transgender, given the really awful and mean-spirited and false things that Director Severino has said so many times about transgender people," she said.

In a public statement, NCTE executive director Mara Keisling said that Severino has "made attacking women's and LGBT people's access to health care one of the centerpieces of his career," and that his statements regarding transgender people are totally baseless and "betray a fundamental misunderstanding of federal civil rights laws, medical science, the reality of what it means to be transgender." This is most worrying because, as she noted, "Mr. Severino is now in a position to transform his dangerous rhetoric into action that can inflict serious harm on the lives of millions of Americans."